Provider Demographics
NPI:1255524773
Name:BERMAN, MELISSA S (MS, RD LD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:S
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MS, RD LD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:S
Other - Last Name:NODVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:8343 ROSWELL RD
Mailing Address - Street 2:SUITE 323
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2810
Mailing Address - Country:US
Mailing Address - Phone:404-414-1112
Mailing Address - Fax:213-286-0025
Practice Address - Street 1:5485 LINGER LONGER RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9091
Practice Address - Country:US
Practice Address - Phone:404-414-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001144133V00000X, 133VN1201X
GA001144133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic